Regional PAE Coordinator (Pre-Admission Evaluation) Job at Community Care Center, San Diego, CA

ek1SVWtIZ1ExYUJsQmtYUFUxZEhWMGg2Nmc9PQ==
  • Community Care Center
  • San Diego, CA

Job Description

Regional PAE Coordinator

The Regional PAE Coordinator is responsible for managing all Pre-Admission Evaluation (PAE) and PASRR for multiple Skilled Nursing Facilities within an assigned region. This role plays a critical part in supporting census growth, preventing admission delays, ensuring regulatory compliance, and improving referral conversion rates. The Regional PAE Coordinator serves as the central liaison between hospitals, facility admissions teams, nursing leadership, managed care organizations, and state authorization agencies.

Duties and Responsibilities:

  • Centralized Authorization Management
  • Complete and submit PAE/ PASRR applications accurately and timely for all assigned facilities.
  • Review referral documentation to ensure clinical and regulatory requirements are met prior to submission.
  • Track all pending authorization requests and follow up proactively to secure timely approvals.
  • Prioritize submissions based on urgency, bed availability, and facility census needs.
  • Admissions Coordination Support
  • Partner closely with Admissions Directors, DON's and facility leadership to facilitate timely patient transitions.
  • Communicate approval status and anticipated timelines to referral partners and internal teams.
  • Assist in coordinating same day or expedited admissions when feasible.
  • Identify potential barriers to admission and escalate appropriately
  • Regulatory Compliance
  • Ensure all authorizations are obtained in accordance with state Medicaid, PASRR, and federal admission regulations.
  • Maintain accurate and organized documentation of all submitted and approved evaluations.
  • Monitor validity periods of approvals to prevent expired authorizations.
  • Support survey readiness and compliance audits by providing required documentation.
  • Relationship Management
  • Develop and maintain strong working relationships with:
  • Hospital discharge planners and case managers
  • Managed care authorization representatives
  • State review nurses and Medicaid agencies
  • Facility interdisciplinary teams
  • Serve as a trusted resource regarding authorization requirements and processes.
  • Operational Efficiency and Census Growth
  • Help facilities reduce lost referrals due to authorization delays or incomplete submissions.
  • Support facilities in achieving census targets through timely approval coordination.
  • Identify process improvement opportunities to streamline admission workflows.
  • Reporting and Data Tracking
  • Maintain centralized tracking tools to monitor:
  • Volume of PAE's submitted
  • Approval turnaround times
  • Denials and referral losses
  • Admission conversion trends
  • Provide regular updates and reports to leadership.

Qualifications:

Required:

  • Minimum 2 years experience in Skilled Nursing admissions, utilization review, case management, or Medicaid authorization processing
  • Strong understanding of PAE, PASRR, and managed care authorization processes
  • Ability to manage high-volume referrals across multiple facilities.
  • Excellent organizational and time-management skills
  • Strong written and verbal communication skills

Preferred:

  • LVN or RN license
  • Experience supporting multiple Skilled Nursing Facilities
  • Knowledge of state-specific Medicaid admission regulations
  • Experience with EMR or authorization tracking systems.

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.

Community Care Center

Job Tags

Similar Jobs

Capital One

Senior Administrative Assistant (Administrative Support Assistant III) Job at Capital One

Senior Administrative Assistant (Administrative Support Assistant III) Capital One is seeking an exceptionally bright, self-motivated, and experienced Administrative Support Assistant III. This pivotal role supports multiple executives, ranging from Director to Managing... 

US Tech Solutions

Healthcare Consultant II Job at US Tech Solutions

 ...Position SummaryProvide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issuesDetermines medical necessity/appropriateness... 

Betco Corporation

Regulatory Affairs Specialist Job at Betco Corporation

Entry level/new graduates are encouraged to apply! Company will provide training programs to assist hire. However, previous experience...  ...teams to lead small projects, evaluate product changes, maintain regulatory approvals, and manage regulatory databases.Requirements... 

Action Lawyers, PC

Criminal Defense Attorney Job at Action Lawyers, PC

 ...Job Description Job Description Established criminal defense law firm with many years of experience, is seeking a FULL-TIME Contract attorney in Santa Clarita and surrounding Counties. Will handle own case-load from beginning to end on ALL CRIMINAL CASES including... 

Intuitive Mindset Limited

Leadership Education Program Manager - Washington Job at Intuitive Mindset Limited

 ...Leadership Education Program Manager Remote (U.S.) - Washington Guide individuals toward meaningful personal and professional growth.About the Opportunity Intuitive Mindset is looking for an experienced professional to partner in helping people explore structured development...